ADDITIONAL PAY FORM
NAME: Employee ID (not 927 #):
DEPARTMENT NAME: DEPT NO:

Charge to
Account No:
Fund
Dept ID
Program
Class
Account

Project/
Grant ID
*All requests must include a complete account number
Additional Pay Amount: $ .
Reason for Payment:
( Grants, Stipends, Etc. )
Payroll Effective Date: - - (MM-DD-YY)


My signature below indicates that I have verified there are sufficient funds in the budget listed above to pay for this expense.


Approval Signature Date


Approval Signature (Dean) Date


Approval Signature (Vice President) Date


Please Note:
Submit form to Payroll Services. Please refer to the Payroll
calendar for reporting deadlines.

11/99

http://www.aug.edu/business_office/payroll/forms.htm